Clinical implications of extremely elevated C‐reactive protein among febrile immunocompetent children

Aim To identify the various diagnoses associated with extremely elevated C‐reactive protein (CRP) (>30 mg/dL) among immunocompetent children and to evaluate its clinical implications during emergency department (ED) workup and hospital management. Methods Children (3 months–18 years) with fever in ED were included, retrospectively. The cohort was divided into two groups—‘extremely elevated CRP’ (>30 mg/dL) and ‘highly elevated CRP’ (15–30 mg/dL). Results Included were 1173 patients with CRP 15–30 mg/dL and 221 with CRP > 30 mg/dL. Bacterial infection was more prevalent among the extremely elevated CRP group (94.1% vs. 78.5%, respectively, p = 0.002). Specifically, bacterial pneumonia (52%), cellulitis (7.2%) and sepsis (4.1%) were more prevalent among this group. More of these patients were reported as ‘Ill appearing’ [78 (35.3%) vs. 166 (17.4%), p